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Preoperative Considerations, Instrumentation and Patient Positioning

Last Updated: August 9, 2018

Figure 1: This patient of Harvey Cushing’s underwent a two-stage operation (subtemporal and suboccipital) for resection of a large petroclival cholesteatoma in 1928. This is likely one of the first cases of Cushing’s that demonstrated his technical expertise in handling complex skull base lesions. The upper images depict the patient’s preoperative cranial nerve dysfunctions before both operations. The images in the middle row show Cushing’s incisions for the staged procedures, and the lower images illustrate his intraoperative findings (images courtesy of the Cushing Brain Tumor Registry at Yale University).

Preoperative Considerations

During the preoperative planning stages, every aspect of the operation, from preoperative assessment to the patient’s potential postoperative need for r...